Introducciónigeciclina (Tygacil®, Wyeth Pharmaceuticals) es un antimicrobiano que pertenece a la familia de las glicilciclinas, derivada de la molécula de minociclina, emparentada con las tetraciclinas, que presenta al igual que éstas, un amplio espectro antibacteriano. El desarrollo de este derivado, que incorpora el radical N,N-dimetilglicilamido en la posición 9 de la minociclina, evita los dos principales mecanismos de resistencia a tetraciclinas: la protección ribosomal (genes tetM o tetO), y los condicionados por bombas de eflujo (como tetA-tetE de enterobacterias y Acinetobacter sp y tetK en Staphylococcus sp) y ha mejorado el espectro de acción antibacteriana 1,2 .El mecanismo de acción, al igual que las tetraciclinas, es la inhibición de la síntesis proteica por unión a la sub-unidad ribosomal 30S (uniéndose en una orientación diferente que las tetraciclinas), donde bloquea la entrada del ARN-t al ribosoma 3 .Estudio multicéntrico de la vigilancia de la susceptibilidad in vitro a tigeciclina en Santiago de ChileThe objective of this multicenter study was to determine tigecycline susceptibility rates, measured by agar diffusion, in nine hospitals in Santiago and to compare these rates with other antimicrobials. Each center studied 20 strains per month. All intermediate and fully resistant strains as well as 10% of susceptibile strains were also studied by the broth microdilution method. Overall, 2301 strains were studied displaying the following susceptibility rates for tigecycline: 100% for Streptococcus sp, Enterococcus sp, and E. coli respectively, 99.8% for Staphylococcus sp, 93% for Klebsiella and 80% for Acinetobacter baumannii. For Proteus, Providencia and Morganella the susceptibility rates were 4%. For cefotaxime-resistant Klebsiella and imipenem-resistant A. baumannii susceptibility rates were 95% and 80% respectively. The agar diffusion and broth dilution method were 100% concordant for tigecycline susceptible strains but only 27% for resistant or intermediate strains represented mostly by Acinetobacter baumannii. The majority of these strains (57/59) proved to be susceptible after retesting. The great majority (96,6%) of strains tested from nine Chilean hospitals proved to be susceptible to tigecycline with exception for Proteus, Providencia and Morganella (66% resistance). Using the agar diffusion method for measuring tigecycline susceptibility to A. baumannii may be misleading.
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